I87 Misoprostol as first line treatment of incomplete abortion: Evidence from Sub-Saharan Africa

2009 ◽  
Vol 107 ◽  
pp. S23-S23
Author(s):  
A. Diop
Author(s):  
Esperanza Merino ◽  
Eliseo Pascual

Joint infection is the most common local complication of brucellosis and is a frequent cause of infectious arthritis in endemic areas. Brucellosis is prevalent in countries of the Mediterranean basin, the Near East, South America, and possibly sub-Saharan Africa. Brucella melitensis and B. abortus are the most common species. Arthralgia occurs in 70% of patients with brucellosis, Large peripheral joints are a common site of localized infection. The sacroiliac joint is frequently involved (30–75%) in recent series. First-line treatment is with doxycycline combined with either streptomycin or gentamycin.


2019 ◽  
pp. 1-10 ◽  
Author(s):  
Matthew S. Painschab ◽  
Racquel E. Kohler ◽  
Edwards Kasonkanji ◽  
Takondwa Zuze ◽  
Bongani Kaimila ◽  
...  

PURPOSE To describe the cost of treating diffuse large B-cell lymphoma (DLBCL) in Malawi under the following circumstances: (1) palliation only, (2) first-line cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), (3) salvage etoposide, ifosfamide, and cisplatin (EPIC), and (4) salvage gemcitabine and oxaliplatin (GEMOX). METHODS We conducted a microcosting analysis from the health system perspective in the context of a prospective cohort study at a national teaching hospital in Lilongwe, Malawi. Clinical outcomes data were derived from previously published literature from the cohort. Cost data were collected for treatment and 2-year follow-up, reflecting costs incurred by the research institution or referral hospital for goods and services. Costs were collected in Malawian kwacha, inflated and converted to 2017 US dollars. RESULTS On a per-patient basis, palliative care alone cost $728 per person. Total costs for first-line treatment with CHOP chemotherapy was $1,844, of which chemotherapy drugs made up 15%. Separate salvage EPIC and GEMOX cost $2,597 and $3,176, respectively. Chemotherapy drugs accounted for 30% of EPIC and 47% of GEMOX. CONCLUSION To our knowledge, this is among the first published efforts to characterize detailed costs of cancer treatment in sub-Saharan Africa. The per-patient cost of first-line treatment of DLBCL in Malawi is low relative to high-income countries, suggesting that investments in fixed-duration, curative-intent DLBCL treatment may be attractive in sub-Saharan Africa. Salvage treatment of relapsed/refractory DLBCL costs much more than first-line therapy. Formal cost-effectiveness modeling for CHOP and salvage treatment in the Malawian and other low-resource settings is needed to inform decision makers about optimal use of resources for cancer treatment.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028029 ◽  
Author(s):  
Emmanuel Kiiza Mwesiga ◽  
Noeline Nakasujja ◽  
Linnet Ongeri ◽  
Aggrey Semeere ◽  
Rachel Loewy ◽  
...  

IntroductionAmong patients with psychotic disorders, the ‘duration of untreated psychosis’ (DUP) is a predictor of key outcomes such as symptom remission and quality of life. In sub-Saharan Africa, DUP is up to five times longer than in high-income countries, with many patients going without antipsychotic medication for 5 years or longer. One contributor to this high DUP may relate to cultural norms that drive use of alternative and complementary therapies (ACTs) as first-line treatment strategies, rather than biomedical care with antipsychotic medicine. We aim to1determine the prevalence and factors associated with DUP and ACT use in Uganda, and2Identify factors that drive patient and family choices to use ACT as a first-line treatment strategy.Methods and analysisWe will leverage on an ongoing cohort study at the national psychiatric and teaching hospital in Uganda. The parent study is an observational cohort design following antipsychotic naïve adults with a first episode of psychosis without substance use, HIV/AIDS or syphilis. The embedded study will use a mixed methods design including quantitative assessment of parent study participants with the Nottingham Onset Schedule-DUP to determine the DUP. Qualitative assessment will focus on patient and caregiver perceptions and use of ACT and its impact on DUP among patients with psychosis using in-depth interviews.Ethics and disseminationThe study has received ethical approval from the school of medicine research and ethics committee of the college of health sciences at Makerere University. It has also received institutional support to perform the study from the Infectious Diseases Institute and Butabika hospital. Besides publication of the work in reputable peer-reviewed journals, we hope that this work will lead to evidence-based discussions on the need for early interventions to reduce DUP in Uganda.


2012 ◽  
Vol 119 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Adeniran O. Fawole ◽  
Ayisha Diop ◽  
Alaruru O. Adeyanju ◽  
Oyewole T. Aremu ◽  
Beverly Winikoff

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